Developmental Pattern and Treatment in Colon Diverticular Disease

PURPOSE: Colon diverticula has continuously increased in Korea. This study is to identify the changes in the developmental patterns of colon diverticula and in the methods of treatment. RESULTS: A total of 66 patients who were diagnosed colon diverticular disease and hospitalized at Red Cross Hospital from April 1994 to March 2005 were enrolled. This retrospective assessment was performed by analyzing the hospital records of clinical characteristics such as demographics (age, sex), physical findings, distribution of diverticula, diagnosis methods, applicable treatments depending on severity and the stage of the disease, and complications and recurrences with whether the patient underwent a emergency or an elective operation. RESULTS: The median age was 51.8 years, with 37 males and 29 females. Of the 66 cases, right-side colon diverticula was found in 47 cases, and left side in 15 cases. Transverse and descending colon diverticula occurred concurrently in 2 cases, with 2 entire colon cases. The median number of diverticula per patient was 4.6. Of the 29 operation cases, a right colectomy was done in 10 along with 6 appendectomy and diverticulectomy cases. Postoperative complications occurred in 7 patients, of these 6 occurred in patients who had undergone an emergency operation, and 1 in a patients who had undergone an elective operation; 6 in right colon diverticular disease, and 1 in left color diverticular disease. CONCLUSIONS: Colon diverticular disease has increased with noticeable increases in left side and both-sides diseases. A one-stage operation is mainly performed for surgical treatment while fewer undergo a two-stage operation. Post-operative complications occurred in 7 cases. Exact preoperative diagnosis and an elective operation that allows bowel preparation are regarded as more crucial factors than the extension of the operation in decreasing the developmental rate and the severity of postoperative complications.

Early Developmental and Clinical Characteristics of Autism Spectrum Disorders / 대한소아신경학회지

PURPOSE: Current evidence of the benefits of early intensive behavioral intervention (EIBI) in children with autism spectrum disorders(ASD) is increasing. In order to get the benefits from EIBI, early identification of ASD is essential but a challenge for clinicians. Therefore, we designed this study to know what differs from other developmental disorders in terms of early developmental patterns and clinical and laboratory characteristics. METHODS: Among 518 children diagnosed developmental delay in Ilsan Hospital Developmental Disorder Clinic from April 2001 to January 2005, we analyzed 122 ASD patients as a study group, and 133 mentally retarded(MR) and 101 specific language impaired(SLI) patients as control groups. We used a questionnaire survey to assess past and family history. We performed various kinds of tools for the evaluation of the development, and cognitive and speech functions according to the patients' age. MRI, SPECT, EEG, genetic and metabolic studies were performed as optional tests. RESULTS: The mean age of ASD was 55.9+/-30.7 months and male was predominant in ASD(male:female ratio was 3.2:1). In early developmental history, motor functions are relatively well preserved in ASD(P<0.05). In speech and social milestones, single word speech was noticeably delayed in all the 3 groups. However, there was no appreciable difference in stranger anxiety among the 3 groups. In the developmental evaluation, speech and social functions were most significantly delayed in ASD(P<0.05). There was a significant motor delay in ASD and MR than SLI(P<0.05). In physical examination, a raised rate of macrocedphaly in ASD was not noted. Abnormal EEG findings were significantly noted in ASD and MR than in SLI and MRI abnormalities were least found in these groups. The etiologic diagnosis was much less identified in ASD than MR. CONCLUSION: In an early stage, absence of stranger anxiety was not statistically significant. However, this seems to be an important risk factor for predicting ASD. Motor functions were relatively well preserved in ASD in an early stage. In the developmental evaluation, social and language areas were the most significantly delayed domains in ASD and motor functions were most delayed in MR. Routine MRI studies are not indicated for identifying the etiology in ASD. It was harder to find out the etiology in ASD than MR.

Femoral Head Deformity in Legg-Calve-Perthes Disease / 대한정형외과학회잡지

PURPOSE: To determine the developmental patterns of 4 major deformities of femoral head commonly observed in Legg-Calve-Perthes disease (LCPD): coxa plana, coxa magna, coxa vara, subluxation. MATERIALS AND METHODS: We reviewed the clinical records and radiographs of 85 unilateral LCPD children who were followed up from the early stage of disease to full skeletal maturity. Four major deformities were measured and observed during 3 periods: the active disease stages of avascular necrosis and fragmentation, the healing stage, and skeletal maturity. RESULTS: All four deformities were first observed at early stages of the disease, avascular or fragmentation stage. Appearance rates were 79% in coxa plana, 28% in coxa magna, 35% in coxa vara, and 27% in subluxation. The gradual progression of deformities with time which was demonstrated at the healing stage and at skeletal maturity were observed in all except subluxation. And this gradual increase was supposed to be dependent on the normal bony growth with aging. CONCLUSION: We determined the developmental pattern of major deformities of the femoral head. And this determination will help to understand the natural course of deformity which is clinically important in terms of late osteoarthritis.